A Unique Presentation of Acute Immune Thrombocytopenia Secondary to Helicobacter pylori Infection.

Thrombocytopenia, a condition characterized by low platelet counts, can arise from various causes, including autoimmune diseases. Immune thrombocytopenia (ITP), a diagnosis made by excluding other possible causes, is categorized as primary or secondary, with primary ITP being idiopathic and secondary ITP associated with infections or autoimmune conditions. This study highlights a unique instance of severe thrombocytopenia triggered by Helicobacter pylori infection.

Importance of preovulatory estradiol on uterine receptivity and luteal function.

Animals that exhibited estrus had greater pregnancy success compared to animals that did not exhibit estrus before fixed-time AI (FTAI). Estradiol is synthesized in bovine ovarian follicles under gonadotropin regulation and can directly and indirectly regulate the uterine receptivity and luteal function. Estradiol concentrations at FTAI impacted oviductal gene expression and has been reported to play an important role in establishing the timing of uterine receptivity. These changes have been reported to impact uterine pH and sperm transport to the site of fertilization. After fertilization, preovulatory estradiol has been reported to improve embryo survival likely by mediating changes in uterine blood flow, endometrial thickness and changes in histotroph. Cows with greater estradiol concentrations at the time of GnRH-induced ovulation also had a larger dominant follicle size and greater circulating progesterone concentrations on day 7. Therefore, it is impossible to accurately determine the individual benefit of greater estradiol concentrations prior to ovulation and greater progesterone concentrations following ovulation to pregnancy establishment, as these two measurements are confounded. Research has indicated an importance in the occurrence and timing of increasing preovulatory concentrations of estradiol, but increasing estradiol concentrations by supplementation may not be sufficient to increase fertility. Increased production of estradiol by the preovulatory follicle may be required to enhance fertility through the regulation of sperm transport, fertilization, oviductal secretions, the uterine environment, and embryo survival.

Factors influencing tobacco use behaviour initiation - From the perspective of the Capability, Opportunity, Motivation- Behaviour (COM-B) Model.

Introduction: Non-communicable diseases such as ischemic heart disease, cancer, diabetes, and chronic respiratory diseases are the leading causes of death worldwide, and are associated with tobacco use. The ultimate goal of health professionals and researchers working to combat smoking's extremely harmful health effects is to prevent smoking initiation. Nearly 5500 new smokers are added each day, for a total of almost 2 million new smokers each year. The COM-B model's primary goal is to determine what needs to be done for a behaviour change to occur. Behaviour modification requires an understanding of the factors that drive behaviour. Aim: The current qualitative study intends to explore the factors affecting tobacco use initiation (TUI) using the COM-B model, given the relevance of investigating the factors affecting TUI and the model. Methods: The present qualitative study has used a directed content analysis approach. Seventeen participants who reported having started any kind of tobacco in the last six months were recruited in the study using a purposive sampling method to understand the factors affecting TUI. The data was collected through interviews, and all of the participants were from the Hyderabad-Karnataka region of Karnataka, India (a state which has been reported as having the highest prevalence of cigarette smoking in India). Results: Directed content analysis revealed six categories: psychological capabilities affecting TUI (lack of knowledge about adverse health effects of tobacco, behavioural control, and poor academic performance), physical capabilities affecting TUI (lack of better physical resilience), physical opportunities favouring TUI (tobacco advertisements, easy access of tobacco products, and favourite star smoke on screen), social opportunities favouring TUI (peer influence, tobacco use by parents, tradition of hospitality, tobacco use as a normal behaviour, and toxic masculinity), automatic motivation causal factors of TUI (affect regulation, risk taking behaviours and tobacco use for pleasure) and reflective motivation causal factors of TUI (perceived benefits of tobacco, risk perception, perceived stress, and compensatory health beliefs). Conclusion: Identifying the factors that influence TUI may help to limit or prevent people from smoking their first cigarette. Given the importance of preventing TUI, the findings of this study indicated the factors that influence TUI, which can be valuable in improving behaviour change processes.

Development of closed-loop active control method for suppression of thermoacoustic instability using radial air micro-jets.

Thermoacoustic instabilities present in the combustor of power producing devices are having adverse effects on the performance. To avoid thermoacoustic instabilities, design of control method is very much essential. Design and development of a closed loop control method is a real challenge for combustor. Active control methods are advantageous than passive methods. The characterization of thermoacoustic instability is essential for effective design of control method. The selection of appropriate controller and it's design depends on characterization of thermoacoustic instabilities. In this method the feedback signal acquired from microphone is used to control the flow rate of radial micro-jets. The developed method is implemented effectively to suppress thermoacoustic instabilities in a one dimensional combustor (Rijke tube). The airflow to the radial micro-jets injector was controlled using a control unit which consist of a stepper motor coupled with a needle valve, and an airflow sensor. Radial micro-jets are used to break a coupling and act as an active closed-loop method. The control method used radial jets effectively to control the thermoacoustic instability and reduces sound pressure level to background level (100 dB to 44 dB) in short span of time (10 Second).•LabVIEW Interface for Arduino (LIFA), LabVIEW, and DAQ are very useful in developed closedloop active control method.•Developed closed loop active control method is very effective for suppression of thermoacoustic instability.•Developed closed loop active control method used air in the form micro jets to control thermoacoustic instabilities.

Applications, benefits and challenges of telehealth in India during COVID-19 pandemic and beyond: a systematic review.

BACKGROUND: India, the seventh-largest country in the world and the second-most populated faces enormous challenges when it comes to healthcare. The country's healthcare system was close to collapse due to the detrimental effects of the COVID-19 pandemic. Telehealth, which enables treating patients remotely, played a critical role during these challenging times. This systematic review investigates in detail the role of telehealth during COVID-19 and its application beyond the pandemic. METHODS: Database searches on PubMed, Scopus, Science Direct and Web of Science were carried out for studies published on telehealth, and articles were included if they focused on any audio or video telehealth consultation during the pandemic in India. Findings were synthesised into three main themes: applications, benefits and challenges of telehealth services. Methodological quality was assessed using JBI critical appraisal tools. RESULTS: The initial search on databases yielded 1143 articles. Of those, 19 met the eligibility criteria. Findings highlight the effective utilisation of telehealth across multiple medical specialities. Although insufficient technological infrastructure and other barriers due to the virtual consultation challenge the successful implementation of telehealth in India, it has the potential to bridge the rural-urban healthcare divide with cost-effective and easily accessible services. CONCLUSION: High patient/provider satisfaction underscores the need to integrate telehealth into routine healthcare practices in the country. However, the review urges the government and healthcare practitioners to address the telehealth challenges with prime importance to ensure quality healthcare throughout the nation even after the pandemic.

Cognitive style and working memory among adolescents with specific learning disability.

BACKGROUND: In a world where education directly influences the quality of life of an individual, educational handicaps are a grave issue that plagues the lives of those affected. The current study aims to find out whether there is a difference in the cognitive style and working memory capacity among adolescents with specific learning disability (SLD) in comparison to their age-matched equivalent group without SLD. The study also targets to find out if there exists any relationship between cognitive style and working memory. MATERIALS AND METHODS: A total of sixty participants were selected (thirty adolescents with learning disability and thirty age-matched adolescents without learning disability) from Bangalore district of Karnataka and Thrissur district of Kerala using purposive sampling method. The tools used were the Indian adaptation of Embedded Figures Test by Nigam (1997) and the Wechsler Intelligence Scale for Children-Fourth Edition by Wechsler (2003). RESULTS: The results showed that there exists a significant difference in cognitive style dimensions of field dependence and independence between adolescents with learning disability (M = 11.6, standard deviation [SD] = 6.52) and adolescents without learning disability (M = 25.2, SD = 7.33) as well as in the working memory capacity between adolescents with learning disability (M = 66.7, SD = 19.26) and adolescents without learning disability (M = 102, SD = 14.93) groups under study (p < 0.01). The results also indicate that there exists no significant relationship between cognitive style and working memory. CONCLUSION: Adolescents with SLD was found to be field dependent and has low working memory capacity than adolescents without learning disability. The results reflect the need for developing cognitive interventions to enhance working memory capacity and cognitive style for helping adolescents with learning disability in all areas of their functioning, such that the society benefits as a whole.

Trivialization of Aggression Against Women in India: An Exploration of Life Writings and Societal Perception.

Purpose: Aggression, or an action that intend to harm, encompasses different forms with varying intensity, impact, and salient features. Globally and in Indian context specifically, aggression against women is often normalized if there is no physical aggression involved as the hurt caused tends to be invisible. The current study explored the perceived intensity of physical, verbal, and sexual aggression among south Indian adults. Method: Aggressive instances from the life writings of two south Indian women were chosen and were rated by five independent coders to check inter-coder reliability. The select narratives disclose instances of domestic aggression. Ten instances with highest ratings were chosen as the material for data collection. Adults (N = 145) from two southern states had reported the perceived intensity of aggression in each context. Textual analysis and ANOVA were the analytic techniques adopted. Results: The results indicate trivialization of verbal aggression compared to physical and sexual aggression. Further, the instances of verbal or more subtle aggression were perceived as even more trivial when the respondents got exposed to the instances of explicit physical and sexual aggressions first. Conclusions: The findings indicate trivialization of verbal and implicit forms of aggression, particularly when exposed along with physical and explicit forms of aggression. Consequences of different forms of aggression were not considered significant by the respondents. Suggestions for further studies, changes in policy-making, and law-enforcement were made based on the current results.

Emotional Self-Care: Exploring the Influencing Factors Among Individuals With Cancer.

Cancer is a leading source of distress and fatality worldwide. Cancer-related aberrant cell proliferation causes excruciating pain and impairment. To cope with pain and manage symptoms and illness, pharmaceutical and non-pharmacological options are available. Self-care behaviors are recognized as a key source in symptom management and improving quality adherence to treatment among the current non-pharmacological strategies. The intervention measures to improve self-care were hardly impacted because of the narrow focus on physical self-care. Bringing in emotional self-care and addressing the individual's emotional health can enhance the effectiveness of interventions on a holistic level. Hence, this study has attempted to explore the factors that influence emotional self-care among individuals with cancer. Following an exploratory research design, the data were collected from 15 participants (4 men and 11 women) using purposive sampling and semi-structured interviews. Through thematic analysis, eight major themes were identified: physiological factors, social factors, family factors, psychological factors, individual factors, socioeconomic factors, cultural factors, and spiritual factors. The findings explained the emotional self-care among patients with cancer and how different identified factors influence their emotional self-care practices.

The psychological impact of quarantine due to COVID-19: A systematic review of risk, protective factors and interventions using socio-ecological model framework.

Background: Though quarantine is a pertinent control measure for the spread of COVID-19, it is equally important to consider its negative impacts, as it causes severe psychological, emotional, and financial problems not only for those who are quarantined but also for many others who are directly or indirectly connected to those who are quarantined. There appears to be a need to synthesise the available literature evidence on the psychological impact of quarantine experience, especially the multilevel risk factors that make individuals vulnerable to psychological impact and the protective factors to deal with the negative effects of quarantine. Objective: This systematic review attempted to identify the various psychological impacts associated with the experience of quarantine, the risk and protective factors and list out various psycho-social interventions that can minimise the risks and facilitate the protective factors associated with the experience of quarantine. Methods: A systematic search adhering to the PRISMA guidelines was performed in four databases PubMed, Scopus, PsycNet, Web of Science and 10518 articles related to COVID-19 and quarantine were obtained. After screening processes and quality assessment using standard checklist 74 articles that fulfilled the eligibility criteria were chosen for the final review. Findings: Individuals subjected to quarantine had anxiety, depression, post-traumatic stress symptoms, sleep problems, and somatic difficulties. Some of the key risk factors during quarantine are young age, female gender, low money, fear of infection, poor sleep quality, reduced physical activity, increased sedentary behaviours, and a lack of social support. Financial difficulties and stigma remained risk factors even after the quarantine period had ended. Key protective factors were coping skills, home based exercise, leisure, recreational activities, maintaining relationships using social media and availability of mental health services. The findings also highlight the necessity for tele mental health interventions to address the psychological effects of quarantine. Conclusion: Multilevel interventions are required to minimise the impact of risk factors and enhance protective factors.

Determinants of quality of life in individuals with chronic low back pain: a systematic review.

OBJECTIVE: Chronic low back pain (CLBP) is a prominent medical condition that can affect an individual at some point in their life time which could lead to poor quality of life (QOL). Low back pain has affected approximately 577 million individuals globally by 2017. The aim of the current systematic review is to synthesise the existing evidence on the factors influencing the QOL in individuals with CLBP and to identify strategies to improve their QOL. METHOD: PubMed, ScienceDirect, PsychNet and Google Scholar were used to extract studies reporting quantitative relationships between QOL and its possible determinants in individuals having CLBP and the intervention strategies to improve QOL. RESULTS: 10,851 studies were initially identified and twenty-six studies which met the inclusion criteria were selected for the review. 21 studies reported relationship between QOL and potential determinants and five studies assessed the influence of interventions on QOL. Determinants were classified as kinesiophobia, fear avoidance belief, or pain belief; occupation-related factors; pain and disability; activity; personal factors including age, gender, employment status; and other psychological factors including anxiety, quality of sleep, and health locus of control. Intervention strategies including MBSR, Pilates method and Back School Programme improved QOL in individuals with CLBP. CONCLUSION: Psychosocial factors as well as the physical status of the individual contributed to the QOL in individuals having CLBP.

Factors influencing self-care behavior of socio-economically disadvantaged diabetic patients: A systematic review.

Diabetes mellitus and its complications carry broad financial misfortune to the diabetic patients and their family, to the well-being frameworks, and to the public economies through direct clinical expenses and decreased work efficiency. The present study systematically reviewed the possible factors that are influencing self-care behavior of disadvantaged diabetic patients that contribute heavily to the management of this chronic illness. Structured searches were conducted on PubMed, ScienceDirect, and manual searches on Google Scholar for articles published between the years 2000 and 2020. The review was limited to a particular time frame due to the change in WHO criteria for diagnosis and classification of abnormal glucose tolerance. Initially, 96858 articles were identified, and following the screening and full-text reading, 10 studies that met the inclusion criteria were chosen for systematic review. Seven studies had reported the factors influencing self-care behavior among disadvantaged diabetic population. Three studies had reported the importance of intervention strategies and its impact on self-care behavior among them. Findings show that self-care management of socio-economically disadvantaged people entails dimensions including diabetes knowledge, lack of physical activities, social support, lack of access to services, life disruptions, denial of illness, societal attitudes, responsibilities, and treatment costs. It was additionally discovered that diabetes self-management support mediations are successful in drawing in lower economy patients, tending to contending life needs and hindrances to self-care, and encouraging behavior change. Taken together, future methodologically efficacious studies that establish health promoting behaviors and explorations of the factors influencing self-care behaviors of disadvantaged diabetic patients are needed.

Why is hospice care important? An exploration of its benefits for patients with terminal cancer.

BACKGROUND: Palliative care has proven over time that it can help prolong life spans with the use of hospices. The literature reports that most patients with cancer are diagnosed in the later stages and since there is no cure, they will require palliative care at some point during their illness. However, most developing countries, including India, have failed to establish hospices; as a result, large numbers of cancer patients are still deprived of palliative care. To initiate better access to hospices, it is important to understand the benefits of the same. Therefore, the present study aims to explore the advantages of hospice care from the perspectives of advanced cancer patients living in hospice centres. METHODS: The present study uses the method of exploratory research. Using purposive sampling, 8 participants living in a hospice in Bengaluru, India were selected and semi-structured interviews were conducted to collect data from the patients. This data was analysed using thematic analysis. Any underlying patterns were determined to identify the evident themes that emerged from the data. RESULTS: After thematic analysis, 4 themes were identified, namely, pain management, altruism, a good death, and overall satisfaction. Within some themes, there were specific sub-themes that have been illustrated using direct quotes from the interviews. CONCLUSION: The findings of this study suggest that hospice centres play an important role in helping patients to come out of the trauma during the advanced stages of cancer. A sense of relief can be given to the patient by implementing palliative care. This is possible by building more hospice centres in the country where all individuals, irrespective of their financial status, can opt for the service. Having palliative care will provide dignified death to the patients.

Exploring the problems faced by patients living with advanced cancer in Bengaluru, India.

PURPOSE: Cancer is a key influence on psychosocial and emotional distress among patients. Problems that advanced cancer patients in the western world face have been widely explored, but these findings may not be applicable in the non-western world due to the cultural differences. Exploring the problems of advanced cancer patients will help professionals plan appropriate therapeutic interventions to take care of the patients' physical, emotional, social and practical needs. Hence, this study aims to explore the psychosocial and emotional problems of advanced cancer patients in India. METHODS: Data were collected from 10 advanced cancer patients from Bengaluru, using purposive sampling and semi-structured interviews. The interviews were audio-recorded and transcribed. Themes were generated using thematic analysis. RESULTS: The prevalent themes were financial instability, hopelessness, family anguish, self-blame, helplessness, anger, stress, and suicidal thoughts. CONCLUSION: This research has highlighted that advanced cancer patients have several issues, indicating the importance of using a holistic approach while handling this vulnerable population by focusing more on the patient rather than the disease.

Family violence during COVID-19 and its impact on mental health of children: A systematic review.

Purpose: The COVID-19 pandemic posed unanticipated challenges that could impact how the family system operates across the world. Restrictions imposed to control the rapid spread of the virus substantially increased violence in families. The current study aims to review violence in the family and its impact on the mental health of children during the pandemic.Method: A systematic search was conducted using keywords in the electronic databases PubMed, PsycINFO, and Web of Science, and a manual search was conducted on Google Scholar for articles from January 2020 to January 2021. Of the 50 records identified, seven studies that met eligibility criteria were selected for final analysis.Results: Results revealed that family violence during the pandemic has escalated the mental health problems of children, including aggressive and self-harming behaviours. Lockdown restrictions, social detachment, financial instability, fear of infection, and unemployment led to increased parental stress. Parents with a higher level of stress were more likely to maltreat their children.Conclusions: Exposure to short and long-term family violence can adversely impact the mental health of children and can negatively affect a child's present and future life. Recommendations for researchers, mental health practitioners, public health authorities, and other service providers are also outlined.

Effects of L-theanine on posttraumatic stress disorder induced changes in rat brain gene expression.

Posttraumatic stress disorder (PTSD) is characterized by the occurrence of a traumatic event that is beyond the normal range of human experience. The future of PTSD treatment may specifically target the molecular mechanisms of PTSD. In the US, approximately 20% of adults report taking herbal products to treat medical illnesses. L-theanine is the amino acid in green tea primarily responsible for relaxation effects. No studies have evaluated the potential therapeutic properties of herbal medications on gene expression in PTSD. We evaluated gene expression in PTSD-induced changes in the amygdala and hippocampus of Sprague-Dawley rats. The rats were assigned to PTSD-stressed and nonstressed groups that received either saline, midazolam, L-theanine, or L-theanine + midazolam. Amygdala and hippocampus tissue samples were analyzed for changes in gene expression. One-way ANOVA was used to detect significant difference between groups in the amygdala and hippocampus. Of 88 genes examined, 17 had a large effect size greater than 0.138. Of these, 3 genes in the hippocampus and 5 genes in the amygdala were considered significant (P < 0.05) between the groups. RT-PCR analysis revealed significant changes between groups in several genes implicated in a variety of disorders ranging from PTSD, anxiety, mood disorders, and substance dependence.

Stethoscopes: what are we hearing?

This paper develops an objective methodology to test the audio quality of stethoscopes, classifies stethoscopes into five functional categories, and compares the audio performance of each of the five categories. These categories, based on the manufacturer's recommended use, are basic assessment, cardiology, disposable, high-end cardiology, and physical assessment. The classification into categories is based on the intended performance of the stethoscopes as provided by the manufacturers. After developing the procedures and running more than 500 tests, the stethoscope with the least amount of loss over the spectrum was chosen from each of the five categories; the five were then compared to one another. Thirty-nine stethoscopes from 11 manufacturers were used in this study. The objective test methodology allows for side-by-side comparison of stethoscopes from various manufacturers that is independent of the manufacturer's published test results.

Characterization of the Southwestern Desert Aerosol, Meadview, AZ.

Sulfate, organic carbon, and soil dust were the major components of the fine aerosol at Meadview, AZ, during the summer of 1992. Sulfate mass median diameters (typically 0.15-0.27 µm) were much smaller than mass median diameters for organic carbon (typically 0.43-0.83 µm). Organic carbon size distributions were broader and more varied. Intersampler comparisons show that sulfur and sulfate measurement technology provided precise and relatively accurate (within 2-22%) concentrations. However, large differences were observed between IMPROVE filter and MOUDI impactor carbon concentrations. This is indicative of the large uncertainties with which carbon concentrations are measured. The IMPROVE backup filter subtraction procedure was partially responsible for these differences. Meadview sulfate was not completely neutralized by ammonium; SO2 concentrations were comparable to sulfate concentrations; and virtually all of the nitrate was present as gas-phase nitric acid. Our estimates suggest that primary organic aerosol from urban areas accounts for no more than 24% on average of the organic aerosol found at Meadview, AZ. The remainder is most likely secondary and biogenic OC, as well as OC from local and regional anthropogenic sources.